BOSTON -- The Massachusetts health care system "sprung into action" after a new coronavirus was identified, according to an emergency preparedness specialist at a Boston hospital.
Dr. Paul Biddinger, the chief of emergency preparedness at Massachusetts General Hospital, gave two separate updates at the State House Tuesday, first addressing reporters and the public after meeting with Gov. Charlie Baker and other officials, and then later testifying before lawmakers.
In both instances, Biddinger said the state's hospitals and public health system have been preparing for infectious disease outbreaks since 2002 and 2003, learning lessons about pandemic planning, travel history and personal protective equipment from high-profile ailments like the H1N5 bird flu, SARS, and Ebola.
"I do believe that we are beginning the response to this outbreak from a position of being stronger than we ever have been in the past," he told the Public Health Committee at an oversight hearing on the state's response to COVID-19 respiratory illness caused by the new coronavirus.
Two people have tested positive for COVID-19 in Massachusetts. One of those cases has been confirmed by the Centers for Disease Control and Prevention, while the second remains a "presumptive positive" case as state health officials await a response from the CDC.
As of Thursday, 13 states were reporting a total of 99 cases of the illness, including 10 deaths, according to the CDC.
Biddinger told reporters that Mass General has one of 10 special pathogen treatment centers designated by the federal government, and that the center has been "planning and preparing since 2014 for exactly this kind of outbreak."
He said its tools for staff training, isolation, visitor management and accommodating a potential surge in patients have been "shared widely" in collaboration with public health partners.
"Although it is important to remember that most cases of COVID-19 that we have seen are mild, we note that we do not know what the future of this outbreak may look like," Biddinger said. "And I'm very gratified to know how robustly hospitals have been working together, as well as with their pre-hospital care, long-term care, and public health partners to make sure we have a robust system. Because of the strength of these partnerships, we are confident that we will be able to work together to meet whatever challenges we may face with COVID-19."
Speaking to lawmakers, Biddinger said health care professionals must "communicate extremely carefully with the public about what is recommended and what is safe" and work closely with one another to identify areas where the medical system may eventually become "overloaded" in the event of "sustained transmission" of the virus within communities.
In China and in South Korea, he said, some health care systems have become "overloaded with patients, many of whom do not need medical evaluation and care." He said there could be a situation where people are advised not to seek medical care unless they meet a certain set of criteria.
Sen. Becca Rausch, a Needham Democrat who serves on the Public Health Committee, asked Biddinger about the "sustainability of the emergency preparedness system," noting that the outbreak could last "for quite a while."
"None of us has a crystal ball, but I think we expect at least a couple of months of some phase of this operation, and sustainability's an important question, because frankly, we're all a little tired already," Biddinger replied.
He said staff fatigue is being studied and there are plans that can be put in place for longer shifts, rotations of staff and support protocols "if we really need to surge up."
Biddinger testified alongside Dr. Davidson Hamer, an infectious diseases specialist and Boston University professor of global health and medicine, and Dr. Michael Mina, an assistant professor of epidemiology at Harvard's T.H. Chan School of Public Health.
Hamer said that while the disease "can be very mild" for many, it can "cause severe disease and potentially be fatal" for older individuals and those with ongoing medical problems. There is currently no vaccine or treatment.
"One area that we really need attention on are more vulnerable populations, including nursing home residents, and helping them prepare," he said.
Earlier this week, Massachusetts Senior Care Association President Tara Gregorio said her group's members "are taking necessary precautions to ensure the safety of our residents and staff, including use of personal protective equipment, posting signage at entrances and throughout our facilities on best practices, providing alcohol-based hand sanitizer, and asking those with respiratory illnesses and those who have traveled out of the country to refrain from in-person visits."
Rausch also asked the panel of doctors for ideas of how state lawmakers can help the medical community.
Mina answered that one of the "greatest pinch points" facing the field is technical staff. He said the discussion of pay for hospital staff might be a discussion for the private sector rather than the Legislature, "but the discussion is a real one."
"Technical staff has been difficult in hospital settings for a long time, in molecular biology labs, all these things, because -- especially in Boston -- they get sucked up into industry and paid a lot more," he said.
He also pointed to the state's Life Sciences Fund and other initiatives to support biotechnology in Massachusetts, amid worldwide efforts to better understand the virus and potentially develop a vaccine.
"That type of funding is what's needed for, sort of, global translational science to really progress and help the entire globe," Mina said.
On Wednesday, U.S. Sens. Elizabeth Warren and Ed Markey announced that the CDC awarded $500,000 in initial funding to Massachusetts to support efforts to address a potential COVID-19 outbreak, to assist with costs including lab equipment, supplies, staffing, infection control and the monitoring of travelers. That money is separate from the $8.3 billion emergency funding bill the Senate passed Wednesday.
The emergency appropriations bill includes $826 million for the National Institute of Allergy and Infectious Diseases for research and development of vaccines, therapeutics, and diagnostics, along with $61 million to the Food and Drug Administration for work on countermeasures, therapies and vaccines; monitoring and mitigation of any medical product shortages; and supporting the U.S. medical product manufacturing sector, according to a summary.
Also Wednesday, 62 state lawmakers sent a letter to Gov. Baker, urging him to follow New York Gov. Andrew Cuomo and require that insurers waive patient cost-sharing associated with COVID-19 testing.